| NPI | 1699077594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A113321) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD61409413) |
| Enumeration Date | 2010-11-28 |
| Last Update Date | 2023-08-14 |