| NPI | 1487148987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 29236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-7550) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2021-08-16 |