| 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 |