NPI | 1053773358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 208D00000X General Practice (Licence: MD D0086426) |
Enumeration Date | 2016-03-25 |
Last Update Date | 2021-08-11 |