| NPI | 1588382873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0029375) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2026-05-14 |