| NPI | 1932637675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ND 20194) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA R-10896) |
| 207R00000X Internal Medicine (Licence: WI 73268-20) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IA R-10896) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA R-10896) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA R-10896) | |
| 207R00000X Internal Medicine (Licence: IA R-10896) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IA R-10896) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 73268) | |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2025-10-20 |