NPI | 1932497526 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 49647) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R72876) |
Enumeration Date | 2011-07-15 |
Last Update Date | 2015-06-05 |