NPI | 1831779644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.016912) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH Training) |
Enumeration Date | 2021-04-14 |
Last Update Date | 2024-07-16 |