| NPI | 1255694238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A142010) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301100831) |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2024-08-12 |