NPI | 1225056807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C55322) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD37991) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2015-07-22 |