| NPI | 1417122615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A116567) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 233481) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2022-02-11 |