| NPI | 1316301302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35.135086) |
| 207R00000X Internal Medicine (Licence: OH 35.135086) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2025-06-19 |