| NPI | 1275099699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM DO2022-0006) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 7031) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2024-08-22 |