NPI | 1235627456 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A182763) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 20843) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-24 |
Last Update Date | 2022-11-03 |