| NPI | 1841787611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID O-2015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036156716) |
| 207R00000X Internal Medicine (Licence: AZ 10439T) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2025-08-11 |