| NPI | 1255352001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME0142654) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A98661) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-07-27 |