| NPI | 1093465023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 011480) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 0000000) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM 1093465023) | |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2025-05-02 |