NPI | 1245469345 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C173261) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD461643) |
Enumeration Date | 2009-07-09 |
Last Update Date | 2023-11-08 |