NPI | 1699715953 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G41212) |
Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA G41212) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2012-01-24 |