| NPI | 1134137722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A104792) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00027258) |
| 207P00000X Emergency Medicine (Licence: CA A104792) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2022-08-22 |