| NPI | 1518014471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A103475) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD28163) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2024-11-12 |