| NPI | 1750429163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA11184) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CA NONE) |
| 363AM0700X Physician Assistant Medical (Licence: CA 11184) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2023-03-07 |