| NPI | 1548218308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A85128) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47206) |
| 207Q00000X Family Medicine (Licence: CA A85128) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2023-01-05 |