| NPI | 1407940075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A66885) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA a66885) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA a66885) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-01-20 |