NPI | 1144683681 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2019-01413) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.027835) |
207R00000X Internal Medicine (Licence: OH 35.135803) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-01 |
Last Update Date | 2024-02-28 |