NPI | 1598119216 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.152557) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 304237) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-19 |
Last Update Date | 2021-11-22 |