NPI | 1770999468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C177581) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101268765) |
207P00000X Emergency Medicine (Licence: FL ME131478) | |
Enumeration Date | 2014-07-02 |
Last Update Date | 2025-09-18 |