| NPI | 1295114122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A156161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116027986) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2018-10-31 |