| NPI | 1033777578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MO 2022019819) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R-11504) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2024-05-01 |