| NPI | 1891815171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 228471) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A131706) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2022-02-11 |