NPI | 1356364871 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G83720) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G82720) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2017-03-22 |