| NPI | 1760604003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A73598) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A73598) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-12-13 |