| 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 |