| NPI | 1639300106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A11637) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A11637) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-08-01 |
| Last Update Date | 2025-03-17 |