NPI | 1770018921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 62080) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 62080) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-25 |
Last Update Date | 2020-12-29 |