| NPI | 1053706291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 179053) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 274450) |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2022-07-15 |