NPI | 1568896967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U5727) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 49051) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-08-21 |
Last Update Date | 2023-10-02 |