NPI | 1043717283 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A174075) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A174075) |
Enumeration Date | 2018-04-12 |
Last Update Date | 2023-10-01 |