| NPI | 1497799688 |
|---|---|
| Former Name | WAYNE DION STARKS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA C50845) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA C50845) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CA C5845) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-10-26 |