| NPI | 1801908439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA g48618) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-12352) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-12-21 |