NPI | 1225490287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102205584) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: VA A69712391) | |
Enumeration Date | 2016-03-28 |
Last Update Date | 2019-09-18 |