NPI | 1851503239 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G57663) |
Additional Taxonomies | 209800000X Legal Medicine (Licence: CA G57663) |
Enumeration Date | 2007-05-05 |
Last Update Date | 2007-07-08 |