| NPI | 1023093556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA C52974) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AL 00024406) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2015-12-03 |