| NPI | 1184658544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-02490) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A73626) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2021-11-22 |