NPI | 1801381736 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 28327) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 070604) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-06-23 |
Last Update Date | 2024-08-06 |