NPI | 1073928883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2022-028321) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301106233) |
208000000X Pediatrics (Licence: MI 4301106233) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301106233) | |
Enumeration Date | 2014-07-01 |
Last Update Date | 2024-08-29 |