NPI | 1396088878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101266650) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0081598) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-02 |
Last Update Date | 2020-09-21 |