NPI | 1184088767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 30255) |
Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 30255) |
208D00000X General Practice (Licence: NE 30255) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-08 |
Last Update Date | 2025-06-26 |