NPI | 1205402245 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG204731) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG204731) |
Enumeration Date | 2021-06-01 |
Last Update Date | 2021-08-11 |