| NPI | 1225175227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A103916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD 092719-0) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-04-05 |