| NPI | 1417593831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-23044) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: HI MDR-7856) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2022-10-03 |