NPI | 1538658836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T1883) |
Enumeration Date | 2018-05-02 |
Last Update Date | 2021-06-15 |