NPI | 1194783530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G73117) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA G73117) |
208D00000X General Practice (Licence: NV 7042) | |
208D00000X General Practice (Licence: CA G73117) | |
Enumeration Date | 2006-05-03 |
Last Update Date | 2024-05-03 |