| NPI | 1982226452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116038942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0096017) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2024-06-21 |