NPI | 1437947868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 1234) |
Enumeration Date | 2025-04-26 |
Last Update Date | 2025-04-26 |