| NPI | 1093851529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO1397) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A9340) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2016-08-11 |