| NPI | 1861636037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: CA 20A11388) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 11012792A) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2021-12-02 |