| NPI | 1326131640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A304810) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CA A30481) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2020-03-06 |