| NPI | 1598297905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A158221) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A158221) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2021-08-31 |