| NPI | 1760527055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A51722) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: CA A51722) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CA A51722) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A51722) | |
| 207R00000X Internal Medicine (Licence: CA A51722) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA A51722) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A51722) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A51722) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2011-04-06 |