NPI | 1962996330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 102846) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MB11795400) | |
Enumeration Date | 2018-06-19 |
Last Update Date | 2025-05-05 |