NPI | 1417698903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301513683) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 197267) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-04-06 |
Last Update Date | 2025-08-07 |