NPI | 1114120474 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C135430) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 21210) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-06-06 |
Last Update Date | 2022-06-20 |