NPI | 1558822528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA LA-320203) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME155035) |
208M00000X Hospitalist (Licence: FL ME155035) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-30 |
Last Update Date | 2024-12-04 |