| NPI | 1023019460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A100612) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD026268) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2014-01-29 |