| NPI | 1003897117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A89837) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 32462) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2019-09-30 |