NPI | 1619171766 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A93831) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA A93831) |
Enumeration Date | 2007-06-13 |
Last Update Date | 2012-02-08 |