NPI | 1235572983 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 134816) |
Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA 134816) |
208D00000X General Practice (Licence: CA 134816) | |
Enumeration Date | 2013-04-12 |
Last Update Date | 2024-05-01 |