| NPI | 1235512757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A167626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D86769) |
| 207P00000X Emergency Medicine (Licence: MI 4301107066) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2022-05-25 |