| NPI | 1831128156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G62634) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G62634) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2008-12-16 |