| NPI | 1871858910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A168815) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301100525) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD60818570) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2021-11-29 |