NPI | 1952835324 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0010070) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R5006) |
208000000X Pediatrics (Licence: KY R5006) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-12 |
Last Update Date | 2024-07-02 |