NPI | 1043673494 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2020-0586) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: FL 140431) | |
Enumeration Date | 2016-04-02 |
Last Update Date | 2023-10-24 |