| NPI | 1104844810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A48849) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: CA A48849) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2024-05-12 |