| NPI | 1265554695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A66747) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A66747) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA A66747) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A66747) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CA A66747) | |
| 207Q00000X Family Medicine (Licence: CA A66747) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A66747) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2022-08-08 |