| NPI | 1962996330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OS02525C) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS025235C) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MB11795400) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 102846) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2026-04-30 |