| NPI | 1992001804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A122736) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY AL4978841-928) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2022-07-21 |