| NPI | 1659696987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A120400) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2018-11-14 |