NPI | 1386006716 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME137268) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME137268) |
Enumeration Date | 2016-03-24 |
Last Update Date | 2022-07-06 |