| NPI | 1497871438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A1006870) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL 25910) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-06-11 |