| NPI | 1588127344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: CA A176986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A176986) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A176986) | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2023-08-31 |