NPI | 1437558111 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17273) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-128957) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-08-19 |
Last Update Date | 2024-06-18 |