NPI | 1164042016 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.164782) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL0008353) |
Enumeration Date | 2020-04-21 |
Last Update Date | 2023-10-05 |