| NPI | 1760830681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD048404) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A171203) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2022-03-10 |