| NPI | 1427164581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A73484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA I25956) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2024-10-16 |