NPI | 1376181206 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 208D00000X General Practice (Licence: IL 125.075457) |
Enumeration Date | 2019-12-10 |
Last Update Date | 2023-05-05 |