| NPI | 1073136651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OK 38245) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 38245) | |
| 208600000X Surgery (Licence: OK 38245) | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2025-06-04 |