| NPI | 1265568471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: LA 301630) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G32176) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2016-07-08 |