| NPI | 1306858139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA C50760) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C50760) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2026-02-02 |