NPI | 1285196766 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20196) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA 39) |
Enumeration Date | 2019-04-03 |
Last Update Date | 2023-11-15 |