| NPI | 1689235723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX bp10090517) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04762) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2024-06-26 |