NPI | 1306309273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 179761) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: CA PTL528) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-09 |
Last Update Date | 2022-06-21 |