| NPI | 1063876324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 20252) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A146730) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2019-08-13 |