| NPI | 1720408123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01083916A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: NC 2017-01867) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2020-06-25 |