| NPI | 1598525743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD H0105629) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 102209874) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: DC DO210012758) | |
| Enumeration Date | 2024-03-22 |
| Last Update Date | 2026-05-01 |