| NPI | 1629707567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 33446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL18678) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2023-04-27 |