| NPI | 1447519947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-22726) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A122655) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2022-07-20 |