| NPI | 1376962423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A18200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC DO81619) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-06-17 |