| NPI | 1205342565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3779) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A19317) |
| Enumeration Date | 2017-12-22 |
| Last Update Date | 2024-12-18 |