| NPI | 1457810731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.148338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T7341) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2023-07-14 |