| NPI | 1699111237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 032.0134101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM A-1997-16) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2023-08-03 |