| NPI | 1124273313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: CA 20A10607) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A10607) |
| 207Q00000X Family Medicine (Licence: CA 20A10607) | |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2020-11-10 |