| NPI | 1487048815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C199446) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD186528) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2024-11-22 |