| NPI | 1235243155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G159851) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA 000043302) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2024-04-01 |