| NPI | 1285671305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A97178) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00044397) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2017-12-15 |