NPI | 1053355461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101271003) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 19148) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2021-04-28 |