| NPI | 1285155440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 272653) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 272653) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 272653) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2017-07-05 |