NPI | 1184034399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CO 63892) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-28 |
Last Update Date | 2020-05-28 |