| NPI | 1285175430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A169489) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME140895) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2021-12-14 |