| NPI | 1942245907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A84937) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A84937) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2024-09-14 |