NPI | 1629425913 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S6739) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2019-0011) |
207R00000X Internal Medicine (Licence: AZ R75708) | |
207R00000X Internal Medicine (Licence: AL MD.43026) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R75708) | |
Enumeration Date | 2016-05-17 |
Last Update Date | 2021-09-13 |