NPI | 1215236443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A130204) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 27699) |
Enumeration Date | 2011-03-28 |
Last Update Date | 2020-08-03 |