| NPI | 1285626515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A13731) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA A13731) |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: CA A13731) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2020-06-13 |