| NPI | 1669670832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A77985) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD432056) |
| 208600000X Surgery (Licence: CA A77985) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2018-07-26 |