NPI | 1265457295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G42212) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G42212) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2021-11-18 |