NPI | 1629572839 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID O-1907) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR DO218202) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-21 |
Last Update Date | 2024-05-29 |