NPI | 1093452468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U7411) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10080329) |
Enumeration Date | 2022-05-17 |
Last Update Date | 2024-05-20 |