| NPI | 1952893125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101267698) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101267698) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2022-04-25 |