| NPI | 1205876240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G56784) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 16310) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-07-23 |