| NPI | 1730610338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD204951) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD204951) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR MD204951) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2023-05-17 |