| NPI | 1447477500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 99762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A95277) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2024-07-11 |