| NPI | 1427022755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR 161224) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C51637) |
| 207P00000X Emergency Medicine (Licence: WA 60717765) | |
| 207P00000X Emergency Medicine (Licence: AZ 37752) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2020-10-02 |