| NPI | 1932726072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125075441) |
| 207R00000X Internal Medicine (Licence: IL 125.075441) | |
| Enumeration Date | 2020-07-04 |
| Last Update Date | 2021-06-08 |