NPI | 1902467400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 694400) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX 694400) |
Enumeration Date | 2019-06-25 |
Last Update Date | 2019-06-25 |