| NPI | 1255368189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 50958) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A89241) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-09-02 |