| NPI | 1649297383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G50344) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MN 25108) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2026-03-11 |