NPI | 1407906027 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A44207) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A44207) |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A44207) | |
Enumeration Date | 2007-01-12 |
Last Update Date | 2023-03-07 |