| NPI | 1962417386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A81052) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A81052) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA A81052) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-11-25 |