| NPI | 1437618246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 116037551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 116037551) |
| 207R00000X Internal Medicine (Licence: FL ME148045) | |
| 207R00000X Internal Medicine (Licence: FL TRN28366) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-06-10 |