| NPI | 1255468245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G70403) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: CA G70403) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-07-08 |