NPI | 1043685407 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO192476) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG177909) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-12-09 |
Last Update Date | 2019-06-26 |