NPI | 1568553030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G30670) |
Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CA 05D0896736) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2010-04-23 |