NPI | 1891729422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA16871) |
Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 16871) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2023-10-23 |