| NPI | 1518293943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A10893) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A10893) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 20A10893) | |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2025-11-19 |