NPI | 1598077059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 23214) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.31819) |
208000000X Pediatrics (Licence: MS 23214) | |
208000000X Pediatrics (Licence: AL MD.31819) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2010-07-12 |
Last Update Date | 2022-05-02 |