NPI | 1316185408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A121355) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME EC091002) |
Enumeration Date | 2009-01-27 |
Last Update Date | 2024-08-19 |