| NPI | 1699099242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C166621) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 259077) |
| 207P00000X Emergency Medicine (Licence: ME MD20943) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2024-03-09 |