| NPI | 1194892000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 065662) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G67893) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2011-04-14 |