| NPI | 1154343374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A71557) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A71557) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2010-09-17 |