| NPI | 1184245672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.148940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.148940) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2024-07-11 |