| NPI | 1912386194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: AL 2308) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 25498) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2022-09-21 |