| NPI | 1396934428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A108241) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.203584) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2010-04-29 |