| NPI | 1215594692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A179858) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA PTL1731) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A179858) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2022-07-18 |