NPI | 1386986545 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2016012954) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: OH 34.011878) | |
Enumeration Date | 2013-03-25 |
Last Update Date | 2016-08-19 |