| NPI | 1013160480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A105792) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: CA A105792) |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2015-02-03 |