| NPI | 1780779041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C53955) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 229293) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2021-11-29 |