NPI | 1417526757 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20425) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20425) |
208D00000X General Practice (Licence: CA 20425) | |
208M00000X Hospitalist (Licence: CA 20425) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-06-22 |
Last Update Date | 2024-07-15 |