| NPI | 1891085924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A135782) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 70780) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2020-03-03 |