NPI | 1417054321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 2OA6194) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA 2OA6194) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2016-08-17 |