| NPI | 1871585349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A94112) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 222272-1) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2022-09-28 |