| NPI | 1558820340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A21148) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-03-29 |