NPI | 1265690838 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 41845) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A101367) |
Enumeration Date | 2008-05-29 |
Last Update Date | 2011-01-28 |