| NPI | 1770043721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD210011421) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: MD D0093828) | |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2023-07-11 |