| NPI | 1538137013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A64109) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A064109) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2012-03-07 |