NPI | 1700347713 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL UO6662) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO6662) |
Enumeration Date | 2019-03-31 |
Last Update Date | 2019-10-26 |