| NPI | 1043988033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2025-01688) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IJEO-R1E0W1) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC IJEO-R1E0W1) | |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2025-07-16 |