| NPI | 1750968665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR.0069603) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: CO DR.0069603) | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2023-12-11 |