| NPI | 1558521682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD187425) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A117174) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2018-06-14 |