NPI | 1285796045 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 0420011586) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VT 0600003293) |
Enumeration Date | 2006-12-15 |
Last Update Date | 2014-09-25 |