NPI | 1619202173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0071726) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: CA A109925) | |
Enumeration Date | 2009-10-16 |
Last Update Date | 2013-05-09 |