| NPI | 1295447662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01098521A) |
| 207R00000X Internal Medicine (Licence: IL 036177007) | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2025-11-21 |