NPI | 1205984739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: CA A29371) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A29371) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2016-12-19 |