| NPI | 1235759614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 34182) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.165072) |
| 207R00000X Internal Medicine (Licence: IL 125.076327) | |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2024-08-01 |