| NPI | 1841290798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A67869) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA a67869) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2026-09-09 |