| NPI | 1124327606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A131266) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-7709) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2024-12-13 |