| NPI | 1235397621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A112209) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A112209) |
| 207P00000X Emergency Medicine (Licence: DC 137205) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2023-05-23 |