NPI | 1730474933 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 13489) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-4021) |
Enumeration Date | 2011-06-15 |
Last Update Date | 2015-07-10 |