| NPI | 1164747853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CA A142024) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A142024) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2017-04-11 |