| NPI | 1689997694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A10781) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 87595) |
| 208D00000X General Practice (Licence: SC 87595) | |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2024-06-27 |