NPI | 1265866164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA 20A13566) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-08-27 |
Last Update Date | 2023-04-04 |