| NPI | 1285258194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A184621) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PTL4583) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2023-09-13 |