| NPI | 1952729428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A140849) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA d6015092) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2018-06-18 |