| NPI | 1194726075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G66231) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 50878) |
| 208D00000X General Practice (Licence: CA G66231) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2022-12-06 |