| NPI | 1740491505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA MD200734) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 200734) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX N3359) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 200734) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2021-03-17 |