| NPI | 1346259918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X (Licence: CA G26474) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G26474) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-01-22 |