| NPI | 1124231139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A9716) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9716) |
| 207R00000X Internal Medicine (Licence: CA 20A9716) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-03-31 |