NPI | 1356697825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS018387) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT-016023) |
207R00000X Internal Medicine (Licence: IN 99107509A) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-08-02 |
Last Update Date | 2022-11-29 |