| NPI | 1952975690 |
|---|---|
| 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: MN 32858) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2025-10-21 |