| NPI | 1477913747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: ND PT14729) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ND 14729) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2023-08-03 |