| NPI | 1326289232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A107029) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ A43024) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2015-04-28 |