| NPI | 1750686028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD MD043933) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A114963) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2016-07-02 |