| NPI | 1043376049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C141538) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2006-01738) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2019-03-13 |