| NPI | 1013965565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 54644) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C36652) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2018-05-10 |