| NPI | 1326224056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MN 107830) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A96955) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2014-12-24 |