| NPI | 1629097399 |
|---|---|
| Other Name | SONORA PRIMARY CARE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G55188) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G55188) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA G55188) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G55188) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-04-06 |