NPI | 1851386080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A14907) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS8199) |
Enumeration Date | 2005-09-14 |
Last Update Date | 2016-10-05 |