NPI | 1902433014 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 208000000X Pediatrics (Licence: UT 12404077-1205) |
Enumeration Date | 2020-03-26 |
Last Update Date | 2023-06-22 |