| NPI | 1669474235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 10935) |
| Additional Taxonomies | 202D00000X Integrative Medicine (Licence: CA A73486) |
| 202D00000X Integrative Medicine (Licence: NV 10935) | |
| 207P00000X Emergency Medicine (Licence: CA A73486) | |
| 208D00000X General Practice (Licence: CA A73486) | |
| 208D00000X General Practice (Licence: NV 10935) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2025-10-16 |