NPI | 1902847320 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A9334) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A9334) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2016-03-15 |