| NPI | 1649204785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A68293) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: CA A68293) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2025-08-27 |