| NPI | 1982615696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A25998) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A25998) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2024-02-27 |