NPI | 1821653759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN32752) |
Additional Taxonomies | 208D00000X General Practice (Licence: FL HSE27921) |
Enumeration Date | 2019-05-06 |
Last Update Date | 2022-04-08 |