| NPI | 1194803817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA g55168) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G55168) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA g55168) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-06-24 |