| NPI | 1649087982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 286500000X Military Hospital |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR SC5940982) |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2026-08-17 |