| NPI | 1649281130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA g59018) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA g59018) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |