| NPI | 1437417029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C170476) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60522339) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2024-04-15 |