NPI | 1144881830 |
---|---|
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: PA OS022166) |
Enumeration Date | 2019-06-24 |
Last Update Date | 2022-07-06 |