| NPI | 1811341480 |
|---|---|
| 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: NE 2171) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2023-11-01 |