NPI | 1447284385 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A36930) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA A36930) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2015-05-05 |