| NPI | 1528017167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A81424) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A81424) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A81424) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2017-05-02 |