| NPI | 1649253691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101013560) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A7838) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2021-11-17 |