| NPI | 1376565119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C54103) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 228435) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-12-15 |