| NPI | 1063698603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A124234) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 234586) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2021-12-20 |