| NPI | 1104071489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA A112706) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A112706) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: CA A112706) | |
| 207R00000X Internal Medicine (Licence: PA MD438678) | |
| 207R00000X Internal Medicine (Licence: CA A112706) | |
| Enumeration Date | 2008-11-30 |
| Last Update Date | 2023-05-26 |