| NPI | 1033564380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A20125) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 007933) |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2022-08-31 |