NPI | 1154841336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0072919) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 7255) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-06-20 |
Last Update Date | 2024-09-04 |