| NPI | 1245734623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME155365) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 164566) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2023-06-22 |