NPI | 1356838494 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301505003) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A193415) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-14 |
Last Update Date | 2024-03-28 |