| NPI | 1477518868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C175307) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 237776) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-06-14 |