| NPI | 1952698433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS T-2463) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 33288) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2016-07-01 |