| NPI | 1356314835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C170935) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 10849) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2024-04-25 |