| NPI | 1538199104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A77851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A77851) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-12-11 |