NPI | 1164166179 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 8374) |
207Q00000X Family Medicine (Licence: AR E-17336) | |
Enumeration Date | 2022-04-25 |
Last Update Date | 2024-05-23 |