NPI | 1356920391 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0069578) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO DR.0069578) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0008569) | |
Enumeration Date | 2021-04-06 |
Last Update Date | 2025-07-22 |