| NPI | 1952757361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01087920A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.142132) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2022-06-30 |