NPI | 1679702724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 52385) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 104488) |
390200000X Student in an Organized Health Care Education/Training Program | |
207R00000X Internal Medicine (Licence: MN 52385) | |
Enumeration Date | 2009-07-10 |
Last Update Date | 2011-06-30 |