| NPI | 1427439983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A19318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME TP15061) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2024-05-02 |