NPI | 1043711070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD489395) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.139460) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-02-25 |
Last Update Date | 2025-06-04 |