| NPI | 1730854258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: WA MD61528549) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2026-02-01 |