NPI | 1356923197 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0008534) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0069518) |
208D00000X General Practice (Licence: CO DR.0069518) | |
Enumeration Date | 2021-04-21 |
Last Update Date | 2023-08-18 |