| NPI | 1841923927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS2022-0944) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2022-0944) | |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2023-05-02 |