| NPI | 1679597835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C55676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 41996) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2016-03-01 |