| NPI | 1750321378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282NR1301X General Acute Care Hospital, Rural (Licence: CA G74686) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60225583) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2025-12-12 |