NPI | 1780245985 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: CA A178133) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A178133) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-06-27 |
Last Update Date | 2024-05-29 |