NPI | 1386105005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2024-0278) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 69100) |
208600000X Surgery (Licence: CT 69100) | |
Enumeration Date | 2019-03-26 |
Last Update Date | 2024-06-25 |