| NPI | 1841453966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A116545) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101280373) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2024-07-11 |