NPI | 1740844208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 344544) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10078200) |
207R00000X Internal Medicine (Licence: IL 125.074412) | |
Enumeration Date | 2019-04-30 |
Last Update Date | 2024-11-27 |