| NPI | 1447363726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A113172) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME EC061110) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2015-10-30 |