| NPI | 1174574404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A89644) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A89644) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A89644) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2010-04-13 |