| NPI | 1114955994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G55818) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CA G55818) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2023-08-10 |