NPI | 1053999797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.168795) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.078357) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-04-01 |
Last Update Date | 2024-09-27 |