| NPI | 1235326836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA ot012172) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA 20A 11722) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2022-02-11 |