NPI | 1154942183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: FL 163205) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 163205) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-04-30 |
Last Update Date | 2024-08-01 |