NPI | 1669891479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A15748) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PG167651) |
Enumeration Date | 2014-04-08 |
Last Update Date | 2017-11-02 |