| NPI | 1063259299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC MTL600001854) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MTL600001854) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-20 |