NPI | 1326665654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0075884) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.253139) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-07-02 |
Last Update Date | 2025-07-06 |