| NPI | 1629056130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine (Licence: CA G29647) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CA G29647) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2024-11-06 |