| NPI | 1467027581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 81340) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD19941) |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2025-07-25 |