NPI | 1770758310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G34800) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA G34800) |
Enumeration Date | 2008-04-24 |
Last Update Date | 2010-08-04 |