NPI | 1104022581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A110685) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2012-00777) |
207Q00000X Family Medicine (Licence: NM rs20070324) | |
Enumeration Date | 2007-06-22 |
Last Update Date | 2023-09-14 |