| NPI | 1174737225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A103581) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 52117) |
| 207Q00000X Family Medicine (Licence: CA A103581) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2021-12-20 |