| NPI | 1245256007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 03321) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A9178) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-04-17 |