NPI | 1639733165 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME154913) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME154913) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-30 |
Last Update Date | 2024-07-12 |