| NPI | 1780857474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A330696) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A33069) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |