NPI | 1780112896 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NY 307633) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-06-02 |
Last Update Date | 2023-10-19 |