| NPI | 1912380346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A157112) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A157112) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2022-03-09 |