| NPI | 1700058377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2015-0752) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 50699) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2024-04-23 |