NPI | 1952764458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C175700) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: NY 279269) | |
Enumeration Date | 2016-04-01 |
Last Update Date | 2022-02-26 |