| NPI | 1770173239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 101YM0800X) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 106H0000X) |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2021-01-19 |