| NPI | 1245476852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A37395) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: CA A37395) |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2009-01-02 |