| NPI | 1619361169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01089605A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 133989) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2023-10-05 |