NPI | 1205462249 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1013792) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.075472) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-22 |
Last Update Date | 2023-07-06 |