| NPI | 1285737569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A35411) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A35411) |
| 207V00000X Obstetrics & Gynecology (Licence: CA A35411) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2023-05-28 |