NPI | 1992369409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A183494) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301507844) |
Enumeration Date | 2019-04-30 |
Last Update Date | 2023-06-06 |