| NPI | 1881659233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A85231) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 34520) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-10-28 |