| NPI | 1083786636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G59030) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G59030) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: CA G59030) | |
| 208D00000X General Practice (Licence: CA G59030) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-09-07 |