| NPI | 1285602573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G78024) |
| Additional Taxonomies | 175F00000X Naturopath |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G78024) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2021-02-17 |