NPI | 1427687078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151016918) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.031344) |
Enumeration Date | 2020-04-06 |
Last Update Date | 2024-06-12 |