| NPI | 1023034501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA 20A9989) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 5101015854) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2018-01-04 |