| NPI | 1629089628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G73848) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 5941300-1205) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2008-05-27 |