| NPI | 1538861208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A211147) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2026-08-19 |