| NPI | 1457317547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A95471) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A95471) |
| 207P00000X Emergency Medicine (Licence: WA MD61351602) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-04-06 |