NPI | 1891107314 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 87169) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT 68251) |
207R00000X Internal Medicine (Licence: MT 87169) | |
Enumeration Date | 2014-06-02 |
Last Update Date | 2023-01-24 |