NPI | 1285334276 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 125.083306) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.083306) |
390200000X Student in an Organized Health Care Education/Training Program | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.083306) | |
Enumeration Date | 2023-03-08 |
Last Update Date | 2025-06-06 |