NPI | 1629505680 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S3750) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
390200000X Student in an Organized Health Care Education/Training Program | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-05-21 |
Last Update Date | 2022-08-30 |