| NPI | 1265775456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD198598) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 100037884) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2020-08-05 |