| NPI | 1972914901 |
|---|---|
| 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: CT 56920) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2022-07-21 |