NPI | 1124139803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A7280) |
Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 20A7280) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2015-05-11 |