NPI | 1659012102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 331434) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V5854) |
Enumeration Date | 2022-04-06 |
Last Update Date | 2025-02-07 |