| NPI | 1144248915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A45736) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A45736) |
| 209800000X Legal Medicine (Licence: CA A45736) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2012-09-24 |