| NPI | 1275878050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-17426) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A123722) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2015-12-09 |