| NPI | 1215472162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD Z-140-081-067-709) |
| Enumeration Date | 2017-01-02 |
| Last Update Date | 2017-01-02 |