NPI | 1588077234 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01088490A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD183681) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-06-10 |
Last Update Date | 2022-09-01 |