| NPI | 1841459583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 11164) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS10398) |
| Enumeration Date | 2008-06-07 |
| Last Update Date | 2020-01-24 |