NPI | 1730310772 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 34710) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 34710) |
207Q00000X Family Medicine (Licence: KY 51820) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-08-06 |
Last Update Date | 2024-07-02 |