| NPI | 1982831806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A119099) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125055435) |
| 207P00000X Emergency Medicine (Licence: CA A119099) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2025-01-06 |