NPI | 1306427927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 195883) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: AZ R78771) | |
Enumeration Date | 2021-04-15 |
Last Update Date | 2024-05-02 |