NPI | 1124717814 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL L5982) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 390200000X) |
Enumeration Date | 2023-05-08 |
Last Update Date | 2023-10-16 |