| NPI | 1710939988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA A26146) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A26146) |
| 207R00000X Internal Medicine (Licence: CA A26146) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A26146) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2025-09-11 |