| NPI | 1932544632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A140418) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A140418) |
| 207Q00000X Family Medicine (Licence: OR MD172169) | |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2023-05-25 |