| NPI | 1063436012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD161649) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A89470) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-02-01 |