NPI | 1538295845 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 43434) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY 43434) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-02-23 |
Last Update Date | 2024-08-30 |