| NPI | 1861074734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RR0500X Internal Medicine Rheumatology (Licence: PA OT023170) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-06-27 |