| NPI | 1861874539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2020-03619) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 209949) |
| 207R00000X Internal Medicine (Licence: NC 209949) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2023-11-27 |