| NPI | 1336386853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 179463) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042-0010229) |
| 207P00000X Emergency Medicine (Licence: CT 047405) | |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2022-08-06 |