| NPI | 1467487868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A8620) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR DO23047) |
| 207Q00000X Family Medicine (Licence: OR do23047) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA 20A8620) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-02-16 |