NPI | 1528753100 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ R80176) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 207Q00000X) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-04-10 |
Last Update Date | 2023-05-02 |