| NPI | 1255647517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 16837) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: CA A113713) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2016-03-22 |