| NPI | 1437140746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA PA14549) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA14549) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2022-04-22 |