NPI | 1851495154 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G198500) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD8841) |
Enumeration Date | 2006-09-08 |
Last Update Date | 2021-05-21 |