| NPI | 1144256355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G85611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME70151) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2023-08-22 |