NPI | 1437492295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD179436) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: PA MT204883) | |
Enumeration Date | 2013-03-30 |
Last Update Date | 2016-08-10 |