| NPI | 1942355391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A106805) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA md422944) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-04-03 |