| NPI | 1033735642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046199) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: MA 1019481) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2024-09-13 |