NPI | 1164840856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA a158035) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A158035) |
Enumeration Date | 2014-03-31 |
Last Update Date | 2019-12-03 |