NPI | 1790364560 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U8377) |
Additional Taxonomies | 208D00000X General Practice (Licence: TX U8377) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-04-07 |
Last Update Date | 2024-10-10 |