| NPI | 1477968428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A171461) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61280989) |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2023-08-10 |