| NPI | 1477038495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2022020239) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022020239) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2022-08-22 |