NPI | 1902363971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101270242) |
Additional Taxonomies | 2865X1600X Military Hospital, Military General Acute Care Hospital. Operational (Transportable) (Licence: VA 0101270242) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-02-26 |
Last Update Date | 2023-11-21 |