| NPI | 1104152511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A125059) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 54298) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2017-09-15 |