| NPI | 1205046570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A11243) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101016919) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-12-15 |