| NPI | 1932148905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A97993) |
| Additional Taxonomies | 207ZM0300X Pathology, Medical Microbiology (Licence: OH 35.092311) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-04-11 |