| NPI | 1841868668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.150771) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 4351047465) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2024-06-28 |