| NPI | 1073181822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NE 9344) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 9433) |
| 207Q00000X Family Medicine (Licence: NE 9344) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2023-08-03 |