| NPI | 1295814408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G50780) |
| Additional Taxonomies | 132700000X Dietary Manager (Licence: CA G50780) |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA G50780) | |
| 207K00000X Allergy & Immunology (Licence: CA G50780) | |
| 207N00000X Dermatology (Licence: CA G50780) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: CA G50780) | |
| 207QA0000X Family Medicine, Adolescent Medicine (Licence: CA G50780) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA G50780) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CA G50780) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA G50780) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CA G50780) | |
| 207R00000X Internal Medicine (Licence: CA G50780) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA G50780) | |
| 208000000X Pediatrics (Licence: CA G50780) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA G50780) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2018-03-06 |