| NPI | 1700814902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G80308) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA G80308) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2020-12-10 |