| NPI | 1770554693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A83581) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME87681) |
| 207P00000X Emergency Medicine (Licence: GA 052341) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2022-02-11 |