| NPI | 1275829665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A124351) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA STUDENT) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2013-07-02 |