| NPI | 1457845828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 70487) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301114996) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 31342) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 70487) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2023-03-20 |