| NPI | 1407022593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301099921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301099921) |
| 207Q00000X Family Medicine (Licence: CA A103702) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2024-04-17 |