| NPI | 1982099263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A159284) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A159284) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2025-07-18 |