NPI | 1144367400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD d0070726) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 1946) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-1946) | |
Enumeration Date | 2007-01-30 |
Last Update Date | 2025-07-15 |