NPI | 1740290535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20a8740) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A8740) |
Enumeration Date | 2006-08-08 |
Last Update Date | 2016-11-07 |