NPI | 1013218908 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C53776) |
Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA C53776) |
Enumeration Date | 2010-11-08 |
Last Update Date | 2018-03-17 |