| NPI | 1285680215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 97-333085-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G27113) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2007-07-08 |