| NPI | 1013053669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A104449) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD AJ4147357) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-12-13 |