NPI | 1083237184 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351046789) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046789) |
Enumeration Date | 2020-05-22 |
Last Update Date | 2020-06-06 |