| NPI | 1407897481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: CA A31816) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: CA A31816) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2023-03-07 |