NPI | 1619387735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 309166-01) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0058312) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-04-28 |
Last Update Date | 2023-11-30 |