| NPI | 1538272885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 53647) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A53647) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2016-07-15 |