| NPI | 1649237272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME148085) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G63685) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2023-03-16 |