NPI | 1619135142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0086929) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.099242) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2008-05-30 |
Last Update Date | 2023-12-04 |