NPI | 1477935906 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 72873) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2018-0269) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT209065) | |
Enumeration Date | 2015-06-20 |
Last Update Date | 2022-12-02 |