NPI | 1114272317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 1103) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 1103) |
2083X0100X Preventive Medicine, Occupational Medicine (Licence: NE 1103) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-07-13 |
Last Update Date | 2024-07-22 |