| NPI | 1861613515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A101876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A101876) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2025-11-14 |