| NPI | 1407847734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA c 43042) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C43042) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA C43042) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA c 43042) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA c 43042) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2014-04-25 |