| NPI | 1770160830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AL 45360) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL L.5469) |
| 207R00000X Internal Medicine (Licence: AL MD.45360) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-07-14 |