NPI | 1801152376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 279645) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A141190) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-09 |
Last Update Date | 2024-01-26 |