NPI | 1982068359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2020019609) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2017020311) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-11 |
Last Update Date | 2020-07-07 |