| NPI | 1053735043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A15194) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 006798) |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2018-07-10 |