| NPI | 1659301752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA G83708) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA g83708) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-03-10 |