NPI | 1184002610 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR PG182916) |
Additional Taxonomies | 208600000X Surgery (Licence: OR PG178008) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-05-17 |
Last Update Date | 2022-07-21 |