| NPI | 1861933871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 008375) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0074143) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2024-09-13 |