| NPI | 1801465935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2024-0019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 94-10538) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2024-05-06 |