| NPI | 1073548764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G34669) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA AK7580699) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2017-04-28 |