| NPI | 1306118393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A6911) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: CA 20A6911) |
| 175L00000X Homeopath (Licence: CA 20A6911) | |
| 133N00000X Nutritionist (Licence: CA 20A6911) | |
| 204R00000X Electrodiagnostic Medicine (Licence: CA 20A6911) | |
| 207QA0401X Family Medicine Addiction Medicine (Licence: CA 20A6911) | |
| 207QB0002X Family Medicine Obesity Medicine (Licence: CA 20A6911) | |
| 207QS1201X Family Medicine Sleep Medicine (Licence: CA 20A6911) | |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: CA 20A6911) | |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2019-07-18 |