NPI | 1043897051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101027953) |
Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101027953) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-03-25 |
Last Update Date | 2024-07-16 |