| NPI | 1811443765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 21749) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 21749) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 32670R) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 34138R) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 33374) | |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2022-01-31 |