| NPI | 1770699506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A51595) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A51595) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-09-06 |