| NPI | 1235196718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A60144) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A60144) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2012-04-18 |