| NPI | 1437181344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00035333) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M7276) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-11-02 |