| NPI | 1225065576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO24715) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A8624) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-03-21 |