| NPI | 1336371384 |
|---|---|
| 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: MD P24246) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2011-06-20 |