NPI | 1750919916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 208D00000X General Practice (Licence: AZ R97097) |
208D00000X General Practice (Licence: AZ R79097) | |
Enumeration Date | 2020-03-31 |
Last Update Date | 2023-03-30 |