| NPI | 1922661339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT230018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 317678) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2024-05-06 |