| NPI | 1093166332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 60330) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: KY 60330) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2025-07-01 |