| NPI | 1669969580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0008X Internal Medicine, Hepatology (Licence: KY 55286) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2022-06-10 |