NPI | 1902337835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02005998A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125069970) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-22 |
Last Update Date | 2020-07-09 |