NPI | 1790527844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.084012) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125084012) |
Enumeration Date | 2024-06-10 |
Last Update Date | 2024-08-12 |