| NPI | 1861401382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G169269) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00033659) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-03-28 |