NPI | 1790893220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 105384) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008414) |
Enumeration Date | 2006-08-25 |
Last Update Date | 2009-01-06 |