| NPI | 1790213775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OR DO220132) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IL 125079814) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2024-09-19 |