NPI | 1710871405 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.086084) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.086084) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2025-06-06 |
Last Update Date | 2025-07-17 |