| NPI | 1447410220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 110703) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 63228) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: GA 63228) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2025-11-14 |