| NPI | 1881936722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AK 145781) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM R10-2013) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2019-12-31 |