| NPI | 1376596312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G50191) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0080374) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-08-08 |