NPI | 1750365045 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: CA C33961) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA C33961) |
2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA C33961) | |
207P00000X Emergency Medicine (Licence: CA C33961) | |
Enumeration Date | 2005-12-01 |
Last Update Date | 2011-12-01 |