| NPI | 1417977315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A76111) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: CA A76111) |
| 207QA0505X Family Medicine Adult Medicine (Licence: CA A76111) | |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: CA A76111) | |
| 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: CA A76111) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-11-27 |