NPI | 1821356791 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 148659) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125067347) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-30 |
Last Update Date | 2021-12-17 |