NPI | 1558711861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 276963) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267812) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-06-16 |
Last Update Date | 2019-07-01 |