| NPI | 1306896048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA C53379) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301070457) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2010-02-03 |