NPI | 1275024119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61204557) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02006523A) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-05-26 |
Last Update Date | 2025-08-22 |