| NPI | 1265485684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G55744) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA G55744) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA G55744) | |
| 207R00000X Internal Medicine (Licence: CA G55744) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-01-26 |