| NPI | 1386831444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C55991) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C55991) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MA 233763) | |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2025-06-19 |