| NPI | 1184821332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A111985) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-8063) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-06-08 |