| NPI | 1689089609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A148771) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R74749) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2018-03-17 |