| NPI | 1013940907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G77712) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G77712) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-06-19 |