NPI | 1144916156 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.082659) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL J52579397121) |
Enumeration Date | 2023-04-13 |
Last Update Date | 2023-06-12 |