NPI | 1700142106 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 04878) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q2686) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-10 |
Last Update Date | 2020-12-18 |