NPI | 1609337955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 326755) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11541500) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-28 |
Last Update Date | 2024-10-22 |