| NPI | 1518443985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC RTL25-0836) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 311192) |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2025-08-20 |