| NPI | 1578943858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A16347) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 37697) |
| 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: CA 20A16347) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2019-11-24 |