| NPI | 1780903203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A146265) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 270013) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2024-01-10 |