| NPI | 1447705678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME133556) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME133556) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN21926) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2021-04-19 |