| NPI | 1124542014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA TMD004936) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.030442) | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2024-06-14 |