NPI | 1366893539 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02005704A) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO5030) |
Enumeration Date | 2016-06-28 |
Last Update Date | 2023-10-04 |