NPI | 1518229178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q8783) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD456556) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-06-11 |
Last Update Date | 2021-03-23 |