NPI | 1366971640 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 67346) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207RH0003X Internal Medicine, Hematology & Oncology (Licence: CT 1.067346) | |
207R00000X Internal Medicine (Licence: RI MD16995) | |
207R00000X Internal Medicine (Licence: RI LP03957) | |
Enumeration Date | 2017-06-08 |
Last Update Date | 2024-04-16 |