NPI | 1902114754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 63774) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 63774-20) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2010-09-15 |
Last Update Date | 2021-02-10 |