| NPI | 1013176551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C142802) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 148679) |
| 207P00000X Emergency Medicine (Licence: AZ 44699) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2021-09-08 |