NPI | 1548821911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 33243) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351044200) |
Enumeration Date | 2019-06-25 |
Last Update Date | 2022-08-31 |