NPI | 1588789218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 2OA5193) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A5193) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2019-11-19 |