| NPI | 1255629994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A129408) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ r72573) |
| 207Q00000X Family Medicine (Licence: CA A129408) | |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2023-09-06 |