| NPI | 1912535105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX U6356) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2026-06-23 |