NPI | 1669725073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D90379) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN1005980) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-10-23 |
Last Update Date | 2022-07-21 |