NPI | 1982897237 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A104852) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A104852) |
Enumeration Date | 2007-08-21 |
Last Update Date | 2011-12-06 |