| NPI | 1568982866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA a170777) |
| Additional Taxonomies | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: CA a170777) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2026-05-27 |