NPI | 1245890375 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 321871) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301507074) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351044758) | |
Enumeration Date | 2019-06-20 |
Last Update Date | 2024-05-08 |