| NPI | 1871295543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID MRM-2227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID 1871295543) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-04-25 |