| NPI | 1043357262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A10039) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI DOS735) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-02-24 |