| NPI | 1336186121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A49983) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A49983) |
| 207P00000X Emergency Medicine (Licence: NY 251090) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-11-01 |