| NPI | 1649659772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 15073) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0060772) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA 15073) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2025-04-28 |