NPI | 1952981011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC DO210012556) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD H0104314) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0102209247) | |
208D00000X General Practice (Licence: FL OS20269) | |
Enumeration Date | 2021-04-13 |
Last Update Date | 2025-08-02 |