| NPI | 1649610890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A151902) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 56517) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2023-05-26 |