| NPI | 1386218089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 1.077714-RES) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125077717) |
| 207R00000X Internal Medicine (Licence: IL 036169535) | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-05-12 |