| NPI | 1801355086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 1024203) |
| 207R00000X Internal Medicine (Licence: MA 1024203) | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2026-01-11 |