| NPI | 1750721262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A139387) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A139387) |
| 207Q00000X Family Medicine (Licence: GA 074496) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2017-03-27 |