NPI | 1114593092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD224525) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG204669) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG204669) | |
Enumeration Date | 2021-06-01 |
Last Update Date | 2025-09-04 |