| NPI | 1821748989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 8179) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM DO2025-0080) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2025-08-13 |