NPI | 1164004305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0073252) |
Enumeration Date | 2021-04-27 |
Last Update Date | 2024-04-28 |