| NPI | 1578664934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A42703) |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: CA A42703) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2012-09-19 |