NPI | 1497487870 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.174051) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125079803) |
Enumeration Date | 2022-06-25 |
Last Update Date | 2025-06-16 |