| NPI | 1598562563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.087786) |
| 207R00000X Internal Medicine (Licence: IL 125.087786) | |
| Enumeration Date | 2025-02-27 |
| Last Update Date | 2026-06-10 |