| NPI | 1083630883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA C35538) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C35538) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CA C35538) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-01-22 |