| NPI | 1033221262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: CA PA14973) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA NP10506) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA PA14973) | |
| 208VP0000X (Licence: CA NP10506) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2023-11-21 |