| NPI | 1477181352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR.0072768) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP05034) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-08-14 |