| NPI | 1710588496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01092098A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.076644) |
| Enumeration Date | 2020-11-08 |
| Last Update Date | 2023-11-28 |