| NPI | 1184679284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2010-00346) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A49567) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2010-07-27 |