| NPI | 1376073478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2021-00985) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2021-00985) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2023-06-28 |