| NPI | 1235707134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301511272) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351048181) |
| 207R00000X Internal Medicine (Licence: MI 4351048181) | |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2024-07-03 |