NPI | 1245526839 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 257259) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 248320) |
Enumeration Date | 2011-06-22 |
Last Update Date | 2014-04-01 |