| NPI | 1952508848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A-13739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP 60163818) |
| 207P00000X Emergency Medicine (Licence: HI DOS - 1264) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2022-09-13 |