| NPI | 1720241300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A125176) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 66135) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2022-02-11 |