| NPI | 1154986339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A20910) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151013448) |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2024-02-12 |