| NPI | 1730379355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036150777) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036150777) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA 20A13096) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX P1098) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125049218) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2020-10-30 |