| NPI | 1326530262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A18916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT018593) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2021-08-04 |