| NPI | 1689091852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60708225) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 149035) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2024-05-23 |