| NPI | 1013546373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA a184847) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PG199405) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2024-09-23 |