| NPI | 1588196232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A169451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-47740) |
| 207R00000X Internal Medicine (Licence: MI 4301502839) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2022-08-02 |