| NPI | 1487349171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG215556) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG215556) |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2024-03-18 |