| NPI | 1083146468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A1699735) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A1699735) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2022-11-11 |