| NPI | 1275812067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME142742) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A142316) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2020-03-23 |