| NPI | 1093826125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G73419) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G74319) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-06-15 |