NPI | 1235205774 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A71725) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A71725) |
Enumeration Date | 2006-11-27 |
Last Update Date | 2016-04-15 |