| NPI | 1215294327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 157401) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2014021729) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2022-11-18 |