| NPI | 1013972520 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA C160186)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2006-1152)  | 
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NC 2006-01152)  | |
| Enumeration Date | 2006-04-18 | 
| Last Update Date | 2024-03-26 |