NPI | 1891310546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A186760) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125076546) |
Enumeration Date | 2020-06-09 |
Last Update Date | 2023-07-10 |