| NPI | 1679033450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2023010810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125073826) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.073826) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2023-06-09 |