| NPI | 1801059555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A110206) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A110206) |
| 207P00000X Emergency Medicine (Licence: CA A110206) | |
| 208D00000X General Practice (Licence: CA A110206) | |
| 208M00000X Hospitalist (Licence: CA a110206) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2024-12-23 |