| NPI | 1205965647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A108496) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD432455) |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2015-04-24 |