| NPI | 1932546603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A15344) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101020307) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2023-09-21 |