| NPI | 1659665214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA 12670) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 12670) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2022-11-14 |