| NPI | 1760640809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD037383) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0069997) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2021-11-23 |