| NPI | 1841559846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 57025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C174268) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2023-10-10 |