NPI | 1043698707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A155979) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT208388) |
Enumeration Date | 2015-05-14 |
Last Update Date | 2024-02-05 |