| NPI | 1497809032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD14216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A93154) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-02-22 |