| NPI | 1306283890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E8855) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A142403) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2017-04-07 |