| NPI | 1740374131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G49502) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 8061) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-12-30 |