| NPI | 1306872841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A86415) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A86415) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-10-13 |