| NPI | 1487688941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G46387) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: CA G46387) |
| 207R00000X Internal Medicine (Licence: CA G46387) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2024-02-16 |