| NPI | 1871751206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: CA C38951) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: CA C38951) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2013-08-26 |