| NPI | 1063660421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A105342) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A105342) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CA A105342) | |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: CA A105342) | |
| 208D00000X General Practice (Licence: CA A105342) | |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-08-28 |