NPI | 1013025865 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A76533) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 262954) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2020-05-08 |