| NPI | 1922595206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 75112) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 24219) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-22 |
| Last Update Date | 2024-01-29 |