| NPI | 1811968530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G52961) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA G52961) |
| 207Q00000X Family Medicine (Licence: CA G52961) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2016-06-08 |