NPI | 1508516360 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 74725) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 32531) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-03-25 |
Last Update Date | 2023-07-11 |