| NPI | 1386848000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA G83975) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G83975) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-03-07 |