| NPI | 1043370026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A6638) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 20A6638) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-04-27 |