| NPI | 1295725513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 25846) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 89106) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2018-03-17 |