NPI | 1952930679 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 2445) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-04 |
Last Update Date | 2022-07-18 |