| NPI | 1316107675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A20649) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA ot012425) |
| 207P00000X Emergency Medicine (Licence: CA 20A20649) | |
| 207P00000X Emergency Medicine (Licence: NM A-1609-11) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2024-05-06 |