NPI | 1770683658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A76860) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2003-01001) |
Enumeration Date | 2006-09-22 |
Last Update Date | 2023-01-25 |