| 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 |