NPI | 1194285296 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A178337) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207Q00000X Family Medicine (Licence: CA PTL404) | |
Enumeration Date | 2019-03-23 |
Last Update Date | 2022-09-24 |