| NPI | 1164849063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A174843) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD61452680) |
| 207P00000X Emergency Medicine (Licence: FL ME130936) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2023-08-17 |