| NPI | 1437358462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA 20A12241) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA OS014951) |
| 208D00000X General Practice (Licence: PA OT012168) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2021-11-29 |