NPI | 1215377742 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101260492) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101260492) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116026404) | |
Enumeration Date | 2013-06-28 |
Last Update Date | 2023-01-27 |