| NPI | 1588933261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A123169) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI 18913) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2023-06-08 |