NPI | 1891744538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A51621) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A51621) |
Enumeration Date | 2006-05-09 |
Last Update Date | 2011-06-24 |