| NPI | 1053991125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A192008) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351048011) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2024-06-07 |