| NPI | 1942861133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0009499) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO TL.0009499) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2023-08-14 |