| NPI | 1174012199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A166714) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2022-07-01 |