| NPI | 1104087063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 267865) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL30921) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2011-08-03 |