| NPI | 1912283318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 20A12022) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 20A12022) |
| Enumeration Date | 2011-10-29 |
| Last Update Date | 2026-03-30 |