| NPI | 1366776908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A118328) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 21967) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2012-06-27 |