NPI | 1477744290 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A101553) |
207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A101553) | |
Enumeration Date | 2007-08-06 |
Last Update Date | 2011-06-21 |