NPI | 1417938408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: TN 0000053672) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD53672) |
390200000X Student in an Organized Health Care Education/Training Program | |
207Q00000X Family Medicine (Licence: TN 0000053672) | |
Enumeration Date | 2005-11-08 |
Last Update Date | 2024-01-23 |