| NPI | 1760770788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD60647799) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D92463) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A167528) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 19500) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 29420) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG172233) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT199009) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2021-09-29 |