NPI | 1922192046 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A9707) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA 20A9707) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2024-09-03 |