| NPI | 1447311261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G146705) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00036871) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2025-07-29 |