| NPI | 1487635694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G56981) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G56981) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA G56981) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2025-04-08 |