NPI | 1912563875 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01088011A) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10061779) |
Enumeration Date | 2019-05-16 |
Last Update Date | 2023-03-13 |