NPI | 1609815224 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G77031) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA G77031) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2023-07-19 |