| NPI | 1841427564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 38891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A108140) |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2011-11-09 |