NPI | 1912915380 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G64747) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA G64747) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2023-07-17 |