| NPI | 1518938638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A73553) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00049344) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-01-06 |