| NPI | 1104053180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-00803) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 52927) |
| 207P00000X Emergency Medicine (Licence: CA A118952) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TN 52927) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2020-06-25 |