| NPI | 1700382322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND 19566) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MN 73575) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2023-07-28 |