| NPI | 1023364866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q6349) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A127999) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2016-10-21 |