NPI | 1104320621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX BP10085730) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A166782) |
390200000X Student in an Organized Health Care Education/Training Program | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-20 |
Last Update Date | 2023-06-19 |