NPI | 1144753062 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036152762) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036152762) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227887) | |
Enumeration Date | 2017-04-07 |
Last Update Date | 2021-07-12 |