| NPI | 1184917056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A13201) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101019366) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2014-07-24 |