| NPI | 1902815350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2015-0007) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A81082) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-06-23 |