NPI | 1467552885 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C170510) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101224073) |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA C170510) | |
Enumeration Date | 2006-09-25 |
Last Update Date | 2023-02-23 |