| NPI | 1982616116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 20A4935) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A4935) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2016-10-19 |