| NPI | 1407091010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A143284) |
| Additional Taxonomies | 1744R1102X Specialist, Research Study |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2022-12-22 |