| NPI | 1063675601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A111458) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: CA A111458) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2020-02-13 |