| NPI | 1598297111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61265573) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 166667) |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2022-09-07 |