NPI | 1356781132 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A166209) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 25319) |
Enumeration Date | 2013-06-26 |
Last Update Date | 2024-10-22 |