| NPI | 1144845132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A184976) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PTL3651) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2023-05-19 |