| NPI | 1841507233 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 14985) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A118266) | 
| Enumeration Date | 2010-09-07 | 
| Last Update Date | 2014-07-23 |