| NPI | 1679686851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A22751) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A21739) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2009-03-23 |