| NPI | 1114125846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A90486) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A90486) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2010-03-01 |