NPI | 1396236402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2021017726) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019891A) |
Enumeration Date | 2018-05-24 |
Last Update Date | 2022-06-02 |