| NPI | 1942037767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA ND-559) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA ND-559) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA ND-559) | |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |