| NPI | 1184903437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2019-0219) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2019-0219) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2025-06-25 |