| NPI | 1770166696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.078706) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2022-06-15 |