| NPI | 1730392150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A107103) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: OH 57.012229) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2016-03-01 |