| 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 |