NPI | 1568995694 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A169591) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 84641) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-05 |
Last Update Date | 2024-12-13 |