| NPI | 1386929719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301098984) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A130076) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2018-10-24 |