| NPI | 1083926919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A104884) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A104884) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2024-06-13 |