| NPI | 1770945370 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA A158462) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A158462) | 
| Enumeration Date | 2016-03-23 | 
| Last Update Date | 2024-02-03 |