| NPI | 1952834897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD h93509) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD h93509) |
| 208D00000X General Practice (Licence: DE C2-0013664) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2025-04-06 |