| NPI | 1912973165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-098781) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA GFE52434) |
| 2083A0100X Preventive Medicine Aerospace Medicine (Licence: IL 036-098781) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: IL 036-098781) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2018-07-26 |