NPI | 1992228670 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 320581) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS16950) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-07-25 |
Last Update Date | 2023-02-13 |