| NPI | 1922345875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 11463354-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A 124167) |
| Enumeration Date | 2013-01-12 |
| Last Update Date | 2021-10-01 |