| 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 |