| NPI | 1679798995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-6598) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR e-6598) |
| 207R00000X Internal Medicine (Licence: GA 64640) | |
| 207R00000X Internal Medicine (Licence: OK 33174) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-10-08 |