| NPI | 1174011647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1014229) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A194884) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2024-10-25 |