NPI | 1497725758 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A92752) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.30306) |
208D00000X General Practice (Licence: CA A92752) | |
Enumeration Date | 2006-01-26 |
Last Update Date | 2017-04-26 |