NPI | 1912691643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WV 2203) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125082316) |
Enumeration Date | 2023-06-06 |
Last Update Date | 2025-09-10 |